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The Case of the New Diabetic

Here's something I get every few months, and I got one yesterday. A newly-diagnosed diabetic gets put on medication and their vision vastly changes. This patient yesterday went from basically plano (prescriptionless) to +4.50 4 days after he starts taking blood sugar medication. Well that's a problem. So Rx him some glasses! Easy, right? To quote sports celeb Lee Corso: "not so fast my friend." He just got put on his 1st medication. There will be adjustments made to his medications in the 1st few weeks/months. Maybe some different medications and maybe some different dosages of the same medications. He flat out told me he was prescribed two medications but one of them "made him feel funny" so he stopped taking it and is going to tell his doc that he is only taking one medication at their visit next week. So what do we do? His Rx is VERY LIKELY to change again, probably as soon as next week when the doc either puts him back on the medication that made him feel funny or changes meds/dosages. Plus his insurance plan makes us use their outside lab - we won't be making his glasses, they'll be made in Maryland or wherever, and they take 2-3 weeks to come in. So if we made him glasses we run the risk of his vision literally changing before the 1st (of many?) glasses order even comes back from the lab. And do you think the insurance company is going to pay for us to change his Rx 1, 2, maybe 3 or more times? NO WAY. Ok so here's how I usually deal with this: I put them in contacts. I measure today's Rx, teach him how to insert/remove and take care of contacts, then load him up on trials. Then I tell him to come back if/when his vision changes after his meds have been changed. I re-take the measurements and change the contact lens Rx and give him more trials. Easy, cheap, fast and quickly adjustable. Then after his Rx and blood sugar has leveled out in a few weeks/months we can remeasure and Rx some glasses that we won't have to remake 5 times. Heck this guy was so impressed with the contacts he may just be a convert anyway.